Melasma: a comparative trial of azelaic acid (20%) cream alone and in combination with tretinoin (0.1%) cream
Keywords:
Melasma, azelaic acid, tretinoinAbstract
Background Melasma is a common acquired disorder of symmetrical hypermelanosis characterized by irregular, light to gray brown macules involving exposed areas of skin. Therapy for melasma is generally difficult especially in dark skin. The open comparative trial was carried out in the outpatient department of ‘BISD’ to compare the effect of azelaic acid (20%) cream alone and in combination with tretinoin (0.1%) cream in the management of melasma. Materials and methods The study was carried out in the outpatient department of ‘BISD’, from 1st May 2002, till 30th April 2003, over a period of 1 year. A total of 48 patients were included in the study. The patients were studied in two groups of 24 each. The group ‘A’ applied azelaic acid cream (20%) twice daily i.e. in the morning and evening. The other group labelled group ‘B’ applied azelaic acid cream (20%) twice-daily plus tretinoin cream (0.1%) in the nighttime. The treatment was advised for a period of 6 months. For the initial 3 months, the treatment was given daily but in the remaining 3 months every alternate day. All the patients were also advised a broad-spectrum sunscreen. Results Forty eight patients belonging to both sexes were included in the study, the age range being 18-40 years. There were 12 males and 36 females. In group “A”, there were 5 males and 19 females, while group “B” comprised 7 males and 17 females. Significant clinical improvement i.e. excellent and good response, was observed in both the groups by the end of 6 months therapy i.e. group ‘A’ 17 patients (71%, p<0.05) and group ‘B’ 19 patients (79%, p<0.05). In group ‘A’, 7 patients (29%) had moderate or no response while only 5 patients (21%) in group ‘B’ showed mild to moderate response. Conclusion Azelaic acid when used in combination with tretinoin is more effective than azelaic acid monotherapy.References
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